Pelvic Organ Prolapse

Treatment

Your treatment will depend on the type of pelvic organ prolapse you have. Your doctor may recommend first treating some types without surgery. However, in most people, surgery is eventually necessary.

• Medications. Menopause results in lower estrogen levels, which weakens the muscles of the vagina. Estrogen replacement therapy (ERT) may strengthen these muscles. However, some people shouldn't use ERT. If you develop symptoms of one type of prolapse, you're more likely to develop other types. Mayo Clinic doctors try to correct all prolapse-related problems at one time.
• Physical therapy. Physical therapy can include electrical stimulation and biofeedback.
  • Electrical stimulation. During electrical stimulation, the doctor applies small electrical currents to certain muscles in your vagina or pelvic floor. The current causes your muscles to contract, which strengthens them.
  • Biofeedback. As you perform pelvic floor exercises, a sensor monitors muscular contractions to determine if the exercises affect certain muscles.
• Surgery. Mayo Clinic doctors use robot-assisted surgery to treat some types of pelvic organ prolapse. Robotic surgery allows your surgeon to make smaller incisions and can shorten your hospital stay. There are different strategies for various types of prolapse.
  • Rectal prolapse (rectocele). Your surgeon will secure the tissue between your vagina and rectum to keep the organ in its proper position. Your surgeon also removes excess tissue.
  • Bladder prolapse (cystocele). Your surgeon will push your bladder up and secure the connective tissue between your bladder and vagina to keep the organ in its proper position and remove excess tissue. If you have urinary incontinence, your doctor will use a bladder neck suspension or sling to support your urethra.
  • Uterine prolapse. If you're postmenopausal or don't want more children, your surgeon may perform a hysterectomy to correct uterine prolapse.
  • Vaginal vault prolapse and herniated small bowel (enterocele). These often occur high in the vagina, so your surgeon may perform the surgery through the vagina or abdomen (for severe vaginal vault prolapse). Your surgeon will attach the vagina to the tailbone at the base of the spine (vaginal vault suspension).

Read more about bladder prolapse (cystocele), rectal prolapse (rectocele), uterine prolapse, vaginal prolapse and herniated small bowel (enterocele) at MayoClinic.com.